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Training Programme

European nursing training programme for clinical expertise in heart failure



AIMS OF THIS CURRICULUM   

OVERVIEW   |  RATIONALE

The primary purpose of this educational initiative is to provide a training programme that will give a nurse advanced knowledge, skills and attitudes based on a holistic view of the patient throughout the continuum of care in order to function as an independent member within the heart failure team.

At the completion of specialist heart failure training, the heart failure nurse should have acquired:

  •  Extended knowledge of heart failure; its causes, natural history, prevention, diagnostics and evidence-based treatment according to guidelines for the individual patient including pharmacological and non-pharmacological therapy, devices and surgery with special emphasize on drug titration.
  • Competency in performing clinical assessment and evaluate symptoms and effects of treatment. 
  • Competency in assessing educational and psychosocial needs and providing patient education, psychosocial support and counselling.
  • Skills to participate in developing and organising a heart failure programme and function as part of a multidisciplinary team and to manage delivery of heart failure treatment and nursing care across primary, secondary and tertiary care including quality assurance

We welcome interest from both nurses and institutions who wish to run the training programme.

For more detailed information on the curriculum, please contact us.

A certificate is presented to all nurses who complete the course.

OVERVIEW

The economic impact of heart failure and the burden of disease to patients and their caregivers continue to increase despite advances in pharmacological therapy.

Individuals with moderate to severe systolic dysfunction still have a very poor prognosis, with more than one third of patients hospitalised yearly and dying within one year of hospitalisation. The number of patients suffering from heart failure has increased as a consequence of decreased mortality from acute myocardial infarction and improved pharmacologic treatment of heart failure.

In order to improve care and reduce health care costs, heart failure management programmes have been implemented in several European countries. Disease management, including heart failure management, can be defined as a multidisciplinary care approach for patients with chronic illness, an approach that coordinates care through the continuum of illness and throughout the various health care systems.

Heart failure management programmes involve correct diagnosis, optimised treatment, follow up after hospitalisation, a patient management plan, easy access to care as well as patient education and psychosocial support. Based on several meta-analyses, it is today the best evidence-based practice to provide heart failure management programmes to the majority of the heart failure patients. Those coordinated actions reduce mortality and hospitalisations as well as health care costs, and may also improve self-care and quality of life. Without structured and specialized follow-up, heart failure patients are at high risk for deterioration that will require a hospital admission.

Nurses are increasingly involved in heart failure care, especially in patient education, follow-up and drug titration. Sweden was the first country in Europe to establish nurse-led heart failure management programmes and there are now programmes in 80 % of Swedish hospitals. There are also heart failure programmes in more than one third of the hospitals in Norway, Denmark, Ireland, the Netherlands, Scotland and Slovenia.

Several other European countries are rapidly developing these programmes, often staffed with specially educated nurses providing discharge planning, structured follow-up and patient education, both pre- and post-discharge. The care is both clinic and home-based and an increasing number of heart failure nurses are based in primary health care.

Most nurses make protocol-led changes in medications, such as up-titrating ACE-inhibitors, angiotensin II receptor blockers, aldosterone receptor antagonists and beta-blockers and decreasing or increasing the daily dose of diuretics. In most programmes, a cardiologist retains medical responsibility and initiates or confirms the medical changes, but in the UK some heart failure nurses are supplementary prescribers with full medical responsibility.
 
Heart failure nurses often have a long experience in cardiac care and a personal interest in heart failure care and treatment. Many nurses have extended responsibilities, interpreting the results from lab tests and echocardiography, initiating and titrating drugs based on changes in physiological status. For legal reasons, written delegation for tasks that represented extended practice may be needed. In the US, many heart failure nurses have a master’s degree and are clinical nurse specialists or nurse practitioners. In Europe, nurses working in heart failure clinics often have numerous years of clinical experience, but they are not necessarily master’s prepared. In Sweden, the UK and the Netherlands there are university courses in heart failure care at degree level. In several other European countries there are shorter courses on how to set up and run a heart failure management programme.

RATIONALE & ROLE OF THE HEART FAILURE NURSE

It is important to delineate the core competencies and clinical responsibilities of the specialized heart failure nurse in contrast to nursing staff with limited training or experience in heart failure disease management.

There are huge differences within and between countries in the education and competencies of registered nurses. There are also legal differences regarding what nurses are allowed to do within their license. Nurses have a unique competence to bring into heart failure disease management programmes. The heart failure nurse with combined knowledge and skills within nursing, pedagogy, social science and cardiology has become an important member of the multidisciplinary team that improves outcomes through delivering follow up, optimized treatment, education and support to patients. Therefore there is a need for a structured, evidence-based and streamlined formal European education curriculum for the training of heart failure nurses.

Information on Nurse Training Fellowship grant